But as early-season storms continue to wallop the nation this month, researchers warn that the traditional wintry slide actually carries some pretty serious risks.

Whether they’re gliding on plain plastic saucers or high-tech snow tubes, children and teens on sleds account for at least 20,820 injuries in the United States each year, according to a first-ever analysis of U.S. emergency room reports.

“I want them to go sledding, I want them to have fun, but we could do a better job,” said Lara McKenzie, principal investigator for the Center on Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, who led the study. “Twenty thousand injuries a year for an activity you can only do a couple days a year is big.”

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Overall, McKenzie and her colleagues estimated that nearly 230,000 children and teens age 19 and younger were treated for sledding injuries in emergency departments between 1997 and 2007. Their work was published in a recent issue of the journal Pediatrics.

“This is a small slice of a much larger pie,” said McKenzie, who figures that the numbers actually are higher because many sledding injuries never make it to the emergency room.

Sledding is dwarfed by injuries caused by other childhood pastimes, of course. About 275,000 kids suffer non-fatal bicycle injuries each year, according to the National Safe Kids USA campaign. About 82,000 kids are treated for trampoline injuries, and about 61,000 kids are hurt skateboarding.

Still, McKenzie said it's important to know how and why kids are hurt when engaged in such a popular winter pastime.

As any parent might expect, kids between the ages of 10 and 14 accounted for largest proportion of injuries, 42.5 percent, followed by children ages 5 to 9, 29.5 percent. Boys made up nearly 60 percent of the cases.

Fractures were the most common injury, accounting for 26 percent of the injuries, followed by bruises and abrasions, 25 percent, and then cuts and sprains at 16 percent apiece. Alarmingly, the head was the most frequently harmed body part, and more than 9 percent of the kids hurt sustained traumatic brain injuries.

Courtesy of Ron Miller

Ian Miller, 12, of Pottstown, Pa., died Jan. 15 after a sledding accident during a Boy Scout snow trip. His parents are working to require helmets at public sledding sites.

Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

One family's loss
That’s the most sobering statistic for Ron Miller, 55, and Holly Wastler-Miller, 52, of Pottstown, Pa. Their 12-year-old son, Ian, was killed late Jan. 15 when the plastic sled he was riding during a Boy Scout snow trip sent him sliding backwards into a metal ski tower, causing massive head trauma.

“Had Ian been wearing a helmet, he would be alive today,” said Wastler-Miller.

His story gained attention after emergency room workers trying to save Ian discovered a Bible verse tucked inside his snow boot. It was James 1:2-4, which urges followers to stay strong in difficult times.

“Clearly, it was a message to us to persevere in the face of this trial,” said Ron Miller, who launched a nonprofit charity, In Ian's Boots, in memory of his son.

Ian’s parents have spent the months since his death working to get public snow parks and ski areas to require helmets for sledders.

“We are not trying to legislate people’s private lives,” Ian’s mother said, noting that their proposal wouldn’t affect people sledding on private property.

So far, it’s been a slow process, said Ron Miller. Washington, D.C., mandates helmets for sledders younger than 16, and in Massachusetts, a bill introduced by Sen. Steven C. Panagiotakos that would require sledding helmets for kids under 13 remains on the docket.

Otherwise, the option of using helmets — typically snow-boarding or bicycling helmets — is up to individuals who may not understand their importance. Before Ian’s accident, the Millers didn’t make their son use one, either, they said.

“We never thought twice to tell him to take a helmet,” said Westler-Miller. “Who knew?”

Steps for safety
McKenzie, the researcher, said she’d like to see helmets recommended for all sledders. However, more research is needed to verify that helmets would actually reduce sledding injuries as much as they reduce injuries for bicycling, for instance.

In the meantime, there are other steps that parents and kids can take to sled safely, McKenzie said. First, make sure to pick a sledding area clear of obstacles. The most common cause of injury, contributing to 50 percent of cases, was collision, which usually occurred when kids slid into fixed objects like trees, poles or benches.

Second, avoid streets and highways. Sledding on streets accounted for only about 2 percent of all injuries, but the kids hurt in those kinds of accidents were more likely to suffer head injuries or be hospitalized, often because they slide into the path of cars, McKenzie said.

Finally, use common sense. Nearly 6,000 kids were hurt while being pulled on a sled behind a vehicle, including cars, trucks, snowmobiles, ATVs and lawnmowers.

“This is one of the most shocking things to me, that that many people were attempting that,” McKenzie said.